Statistically, what is the most likely cause of heart failure?
Coronary Artery Disease/Ischemia
What is the Morphine Milligram Equivalents "MME" conversion rate for PO morphine to PO Hydrocodone and PO Morphine to IV Hydromorphone
PO morphine to PO Hydrocodone: 1:1 (10mg to 10mg)
PO Morphine to IV Dilaudid: 15mg PO morphine to 1mg IV Hydromorphone
What is the genetic mutation associated with hereditary hemochromatosis?
HFE
44-year-old man is diagnosed with COPD
Alpha1-Antitrypsin Deficiency
What was the original title of the first Harry Potter book?
Harry Potter and the Philosopher's Stone
What is the imaging modality of choice for the evaluation of cardiac amyloidosis.
Bonus: What is the finding suggestive of cardiac amyloidosis?
Bonus 2: What additional confirmatory imaging test could you utilize if the above modality is inconsistent with your presumed diagnosis of cardiac amyloidosis?
Cardiac MRI
Bonus 1: late gadolinium enhancement
Bonus 2: If a monoclonal disorder is not identified, 99m-technetium pyrophosphate scintigraphy of the heart may be diagnostic of ATTR amyloidosis
What are the signs/symptoms of an opioid overdose (list at least 3), what do you use to treat, and what is the dose?
Bonus: How much does the OTC medication cost at the CDM
Somnolence, decreased respiratory rate/hypoxia/hypercarbia, miotic pupils, hypotension, hypothermia
Naloxone/Narcan: IV/IM/SQ: 0.04 to 2 mg; may repeat with escalating doses every 2 to 3 minutes, as needed
Bonus $60
What are these things inside of the RBC?
Bonus: What are they made of?
Bonus 2: what condition are these associated with
Howell-Jolly Bodies
Bonus: These are fragments of RBC nucleus that are not removed in maturation.
Bonus 2: B12 deficiency or any form of asplenia
70-year-old man is evaluated for progressive dyspnea.
COPD
Barrell chest, flattened diaphragm, hyperinflation, increased lucency, and decreased vascularity throughout both lung fields.
What is the name of the Magical Map of Hogwarts?
The Marauder's Map
This diastolic murmur is associated with rhythmic changes in the color of the nail bed.
Bonus: give me the eponymic name of this exam finding
Aortic Regurgitation
Bonus: Quincke's Pulse
What is the most efficacious treatment for trigeminal neuralgia?
Carbamazepine
What are the results for laboratory evaluation of anemia of chronic inflammation/disease (Hb, MCV, serum iron, Ferritin, TIBC)
Bonus: what could you see on bone marrow aspiration?
low HB, low MCV, low TIBC, high ferritin
Bonus: stainable iron
37 yo F with recurrent paresthesia's in her bilateral hands and found to have a pulse pressure discrepancy.
Takaysu Arteritis
high-dose oral glucocorticoids (1 mg/kg/d, up to 80 mg/d) with a slow taper.
Guidelines conditionally recommend adjunctive treatment with nonbiologic immunosuppressive medications (e.g., methotrexate, leflunomide, mycophenolate mofetil, azathioprine, and cyclophosphamide) to mitigate glucocorticoid exposure.
If refractory. TNF inhibitor
Where was Harry Potter Born?
Godric's Hollow
What area of the heart is scarred during an ablation for atrial fibrillation?
The pulmonary veins as they enter the left atrium.
Above what Morphine Milligram Equivalents "MME" per day is there a significantly increased risk for overdose
>90 MME/Day
What kind of anemia can you see in parasitic tapeworm infections?
Bonus: what is the scientific name for the tape worm associated with this condition.
Macrocytic anemia 2/2 B12 deficiency
Bonus: diphylobothrium latum
56-year-old man is evaluated for hemoptysis. He has a past history of previously treated cavitary tuberculosis.
Aspergilloma
How many horcruxes did Voldemort create intentionally?
Bonus: name all of the horcruxes
6
Bonus: Tom Riddle's Diary, Marvolo Gaunt's Ring, Salazar Slytherin's Locket, Helga Hufflepuff's Cup, Rowena Ravenclaw's Diadem, and Nagini the snake, Harry Potter
What trial originally compared medical management vs PCI for treatment of stable angina, and what where the outcomes.
COURAGE, 2007
Medical MGMT = PCI (PCI was not superior to medical therapy with respect to the rate of death or nonfatal myocardial infarction at 4.6 years follow-up.)
What is the therapeutic dose ceiling of IV Toradol, and quickly discuss the trial associated with this topic's implications?
10mg (10mg=15mg=30mg)
Effective pain control with less side effects.
28 yo M with past history of full Sickle Cell disease. Presents with chest pain, fever, shortness of breath for 2 days. CXR with RLL focal consolidation. 2/6 systolic ejection murmur without extra cardiac sounds and bilateral crackles in the lower lung. VS: 102.1, pulse 135, 95/62, 85% on 3L NC, RR 26/min. Hemoglobin 7.6,
What is the diagnosis and how do you manage it?
Bonus: what is the post-transfusion target HbS and what is the target serum hemoglobin.
oxygen, incentive spirometry, analgesics, empiric antibiotics, IV fluids, erythrocyte exchange transfusions
classically this is treated by RBC transfusion in mild settings.
Bonus: HbS less than 30% and target hemoglobin level is 10 g/dL (100 g/L).
7-month history of a pruritic rash on the flexural surfaces of her wrists, arms, and legs. The patient was recently diagnosed with hepatitis C virus infection.
Lichen Planus: pruritic, purple, polygonal papule. usually distributed symmetrically on the wrists, flexural aspects of the arms and legs, lower back, and genitals. A reticulated network of white lines (Wickham striae) may be visible on the surface of the papules.
In the movie, what is the password to Dumbledore's office.
Bonus: what is it in the book
Sherbet Lemon
Bonus: Lemon drop